Nokea
Genetic polymorphisms account for differences in metabolism, including:
- A. Poor metabolizers, who lack a working enzyme
- B. Intermediate metabolizers, who have one working, wild-type allele and one mutant
- C. Extensive metabolizers, with two normally functioning alleles
- D. All of the above
Correct Answer: D
Rationale: All listed phenotypes (A-C) result from genetic polymorphisms affecting drug metabolism, making D correct.
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Which statement is not correct about metformin:
- A. Is for internal use only
- B. Reduce weight, apetite
- C. More frequently causes nausea and vomiting comparing with other hypoglicemic drugs
- D. Use for diabetes mellitus type I
Correct Answer: D
Rationale: Metformin is not typically used for type 1 diabetes, which requires insulin, as it acts on insulin sensitivity and hepatic glucose production.
A doctor orders 250 mL of IV fluid to be infused over 1 hour using microdrip tubing (60 gtt/mL). What is the flow rate in drops per minute?
- A. 100 gtt/min
- B. 120 gtt/min
- C. 150 gtt/min
- D. 250 gtt/min
Correct Answer: D
Rationale: Flow rate = (250 mL 60 gtt/mL) ÷ (1 60) = 15,000 ÷ 60 = 250 gtt/min, matching microdrip where mL/hr = gtt/min.
Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include:
- A. Fruity' breath odor and rapid respiration
- B. Diarrhea, abdominal pain, weight loss, and hypertension
- C. Dizziness, confusion, diaphoresis, and tachycardia
- D. Easy bruising, palpitations, cardiac dysrhythmias, and coma
Correct Answer: C
Rationale: Hypoglycemia presents with neuroglycopenic (dizziness, confusion) and adrenergic (diaphoresis, tachycardia) symptoms.
Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because:
- A. It is a long-acting drug with potential for toxicity.
- B. Nitrate tolerance can develop.
- C. Orthostatic hypotension is a common adverse effect.
- D. It must be taken with milk or food.
Correct Answer: B
Rationale: A nitrate-free interval (e.g., after 2 p.m.) prevents tolerance.
The ganglion blocking drugs act by
- A. Competing with acetylcholine at neuromuscular junctions
- B. Preventing release of acetylcholine
- C. Preventing nerve conduction in post ganglionic segment
- D. Preventing catecholamine release or inactivating it
Correct Answer: B
Rationale: Ganglion blockers (e.g., hexamethonium) prevent acetylcholine release at ganglia.